Wave those magic wands, UTA instructors!
Valium (diazepam) is a benzo indicated for treatment of GAD, PD, and SAD. It can also be used for acute management of violent behaviors because of its rapid sedating and calming effect.
Side effects are the same as that of other benzos. Patient teaching is key!
Valium can also be used to treat alcohol withdrawal, though it is not recommended due to the high frequency of doses.
Thursday, November 11, 2010
Ativan
Ativan (Lorazepam) is a benzodiazepine approved for treatment of GAD. It is also used for PD, SAD, and GAD. Agoraphobia is one specific example of something Ativan can help treat.
Like Xanax, Ativan typically is not sleep-producing when given in lower doses. Remember the important patient teaching that goes along with benzos!!
Like Xanax, Ativan typically is not sleep-producing when given in lower doses. Remember the important patient teaching that goes along with benzos!!
Xanax
I need some of this today.
Xanax (alprazolam) is a benzodiazepine used for short term treatment of anxiety. It is mainly used for GAD, PD, and SAD. Xanax is NOT indicated for primary treatment of PTSD or OCD.
One cool thing about Xanax is that it can treat anxiety without the sedative effect some other anti-anxiety medications have. Now, Xanax IS a benzo, so lots of patient teaching comes with it! remind the patient to use birth control, to avoid alcohol, and to decrease caffeine intake. Remind them that tolerance and dependence may occur, and that withdrawal may occur if they stop taking Xanax after daily use for several months.
**Tolerance and dependency can occur.
Xanax (alprazolam) is a benzodiazepine used for short term treatment of anxiety. It is mainly used for GAD, PD, and SAD. Xanax is NOT indicated for primary treatment of PTSD or OCD.
One cool thing about Xanax is that it can treat anxiety without the sedative effect some other anti-anxiety medications have. Now, Xanax IS a benzo, so lots of patient teaching comes with it! remind the patient to use birth control, to avoid alcohol, and to decrease caffeine intake. Remind them that tolerance and dependence may occur, and that withdrawal may occur if they stop taking Xanax after daily use for several months.
**Tolerance and dependency can occur.
Tuesday, November 9, 2010
3rd Drug Class- Benzodiazepines
Benzopiazepines serve three main therapeutic purposes: 1) anxiety 2) insomnia 3) seizure disorders. Benzos can also be used for alcohol withdrawal, but those are their 3 main uses. They work by potentiating (increasing, enhancing) the action of GABA, which is a neurotransmitter that helps control anxiety, aggression, and excitation.
Benzos can cause depression, dependency, or tolerance, so the are only indicated for short term use. There are long acting and short acting benzos, so I'll make sure I mention that for each specific drug. They are CNS depressants, so side effects include drowsiness, sedation, and cognitive impairment. Make sure you remind your patient taking a benzo to avoid consuming alcohol! Birth control should be used if the woman is of childbearing age, because benzos can cause birth defects.
Benzodiazepines include:
Xanax
Ativan
Valium
Serax
Librium
Tranxene
Benzos can cause depression, dependency, or tolerance, so the are only indicated for short term use. There are long acting and short acting benzos, so I'll make sure I mention that for each specific drug. They are CNS depressants, so side effects include drowsiness, sedation, and cognitive impairment. Make sure you remind your patient taking a benzo to avoid consuming alcohol! Birth control should be used if the woman is of childbearing age, because benzos can cause birth defects.
Benzodiazepines include:
Xanax
Ativan
Valium
Serax
Librium
Tranxene
Saturday, November 6, 2010
Quick Atypical Antidepressant Overview
Here's a quick overview:
Pristiq: for depression. Very similar to Effexor.
Cymbalta: for anxiety and depression. Mild side effects. Can treat diabetic peripheral neuropathy.
Effexor: good for treatment-resistant depression. Monitor blood pressure.
Remeron: antianxiety and antidepressive. Faster than SSRIs. Weight gain is common.
Desyrel: antidepressive effects only in high dose. Sedating! Commonly used in combination with others for sleep.
Wellbutrin: antidepressant and smoking cessation aid. Sexual dysfunction and weight gain are NOT side effects. Monitor does! Medication-induced seizures possible.
Typically take 1-4 weeks to work.
Pristiq: for depression. Very similar to Effexor.
Cymbalta: for anxiety and depression. Mild side effects. Can treat diabetic peripheral neuropathy.
Effexor: good for treatment-resistant depression. Monitor blood pressure.
Remeron: antianxiety and antidepressive. Faster than SSRIs. Weight gain is common.
Desyrel: antidepressive effects only in high dose. Sedating! Commonly used in combination with others for sleep.
Wellbutrin: antidepressant and smoking cessation aid. Sexual dysfunction and weight gain are NOT side effects. Monitor does! Medication-induced seizures possible.
Typically take 1-4 weeks to work.
11.6.10 - Pristiq
Pristiq (Desvenlafaxine) is not in our textbooks. I looked it up on the FDA website instead :) It is an SNRI used to treat depression. It is very similar to Effexor.
Headache, N/V/D, drowsiness, and increased suicidal ideation, are common side effects. Do not take Pristiq if you are pregnant or planning on becoming pregnant soon, and do not drink alcohol while taking Pristiq. Like always, do not take with an MAOI!
Headache, N/V/D, drowsiness, and increased suicidal ideation, are common side effects. Do not take Pristiq if you are pregnant or planning on becoming pregnant soon, and do not drink alcohol while taking Pristiq. Like always, do not take with an MAOI!
11.5.10 - Remeron
Remeron (Mirtazapine) is a SNDI, a serotonin norepinephrine disinhibitor. It blocks the receptors that normally inhibit norepinephrine and serotonin. This is an interesting one to me! It is the only drug in this specific class. It has both antianxiety and antidepressive effects, and its antidepressive effects may actually occur faster than SSRIs. Remeron is also an antidote to sexual dysfunction secondary to use of SSRIs.
Side effects include sedation that is increased by use of alcohol, benzos, and other CNS depressants. *Teach your patients about this! Do not use with MAOIs either. Major thing to note: typical increase in appetite, weight gain, and cholesterol with the use of Remeron.
Side effects include sedation that is increased by use of alcohol, benzos, and other CNS depressants. *Teach your patients about this! Do not use with MAOIs either. Major thing to note: typical increase in appetite, weight gain, and cholesterol with the use of Remeron.
11.4.10 - Cymbalta
Sorry, I have some catching up to do. Busy week.
Cymbalta (duloxetine) is another atypical antidepressant. This is also an SNRI, like Effexor, so it blocks the reuptake of serotonin and norepinephrine. It is labeled for treatment of both depressive and anxiety (PD, GAD, OCD and PTSD) disorders.
Cymblata is similar to Effexor. Side effects are generally mild, and include decreased appetite, increased sweating, fatigue, dry mouth, and nausea. Wear sunscreen...photosensitivity is a side effect.
**One unlabeled use of Cymbalta is for treatment of diabetic peripheral neuropathy. It decreases neuropathic pain. Cool!
Take Cymbalta twice a day, swallowing it whole. It usually takes 1-4 weeks to work :)
Cymbalta (duloxetine) is another atypical antidepressant. This is also an SNRI, like Effexor, so it blocks the reuptake of serotonin and norepinephrine. It is labeled for treatment of both depressive and anxiety (PD, GAD, OCD and PTSD) disorders.
Cymblata is similar to Effexor. Side effects are generally mild, and include decreased appetite, increased sweating, fatigue, dry mouth, and nausea. Wear sunscreen...photosensitivity is a side effect.
**One unlabeled use of Cymbalta is for treatment of diabetic peripheral neuropathy. It decreases neuropathic pain. Cool!
Take Cymbalta twice a day, swallowing it whole. It usually takes 1-4 weeks to work :)
Wednesday, November 3, 2010
11.3.10 - Effexor
Effexor (venlafaxine) is an atypical antidepressant that is useful for treatment-resistant chronic depression. Basically, nothing else has worked so far(especially SSRIs), so we're giving Effexor a shot. It is an SNRI (serotonin norepinephrine reuptake inhibitor).
Side effects include hypertension, nausea, insomnia, dry mouth, sweating, agitation, headache, and sexual dysfunction. ***Monitor blood pressure at higher doses with patient with a history of hypertension. Rapid discontinuation can cause withdrawal!
Side effects include hypertension, nausea, insomnia, dry mouth, sweating, agitation, headache, and sexual dysfunction. ***Monitor blood pressure at higher doses with patient with a history of hypertension. Rapid discontinuation can cause withdrawal!
11.2.10 - Desyrel
Sorry... Yesterday's post is going up today.
Desyrel (Trazadone) - not much information on this drug. It is labeled as an atypical antidepressant, but I can't find very much information on how it works. Also, the textbook says that Desyrel is not a first choice for antidepressant treatment, and that high doses are required to see therapeutic antidepressant effects.
Basically know this: Deseryl has a sedative side effect. It is commonly used in combination with other drugs to help with insomnia.
Desyrel does not have anticholinergic side effects (dry mouth, blurred vision, constipation and urinary retention, etc). Weight gain can be a side effect, as well as postural hypotension. One rare but interesting side effect is called priapism... which is a prolonged painful penile erection that may warrant surgery. Ouch!
*Discontinue MAOIs at least 14 days prior to using Desyrel.
Desyrel (Trazadone) - not much information on this drug. It is labeled as an atypical antidepressant, but I can't find very much information on how it works. Also, the textbook says that Desyrel is not a first choice for antidepressant treatment, and that high doses are required to see therapeutic antidepressant effects.
Basically know this: Deseryl has a sedative side effect. It is commonly used in combination with other drugs to help with insomnia.
Desyrel does not have anticholinergic side effects (dry mouth, blurred vision, constipation and urinary retention, etc). Weight gain can be a side effect, as well as postural hypotension. One rare but interesting side effect is called priapism... which is a prolonged painful penile erection that may warrant surgery. Ouch!
*Discontinue MAOIs at least 14 days prior to using Desyrel.
Monday, November 1, 2010
Drug for 11.01.10 - Wellbutrin
Wellbutrin (Bupropion) is a novel, atypical antidepressant, and is a NDRI (norepinephrine dopamine reuptake inhibitor). It works by blocking the reuptake of norepinephrine and dopamine. Dopamine helps control movement and posture, regulate memory, and helps drive sexual and reward-seeking behavior. Norepinephrine deals with attentiveness, emotions, sleeping, dreaming, and learning. That's all just fyi, but you can see why decreased levels of these two neurotransmitters would have effects noted in depression.
Some major advantages to Wellbutrin are that #1, sexual dysfunction is rare when using this drug! Also, very important #2, weight gain is NOT a side effect of this drug. Both are good things :)
Side effects of Welbutrin include agitation, insomnia, headache, nausea and vomiting. The usual dose is 50-300mg/day, and a major side effect in overdose is medication induced seizures. If the patient is already a high seizure risk, watch them very carefully! And last but not least, MAOIs should not be taken while taking Wellbutrin.
**Importnat to note: Wellbutrin can be used as smoking cessation aid.**
Some major advantages to Wellbutrin are that #1, sexual dysfunction is rare when using this drug! Also, very important #2, weight gain is NOT a side effect of this drug. Both are good things :)
Side effects of Welbutrin include agitation, insomnia, headache, nausea and vomiting. The usual dose is 50-300mg/day, and a major side effect in overdose is medication induced seizures. If the patient is already a high seizure risk, watch them very carefully! And last but not least, MAOIs should not be taken while taking Wellbutrin.
**Importnat to note: Wellbutrin can be used as smoking cessation aid.**
2nd Drug Class- Atypical Antidepressants
Ok so I took Halloween off. Hope you enjoyed the holiday!
Atypical Antidepressants are up next. This information seems somewhat scattered and incomplete in the book, so I will do my best to write what I know and can find. Please correct my mistakes!
Just like the name suggests, these medications are used to treat depression. They work in a similar way to SSRIs... they inhibit the reuptake of either serotonin, norepinephrine, dopamine, or a combination of these neurotransmitters. When I go over each drug, I'll go into more detail!
What about side effects? Good question. There are specific side effects for each drug, and they generally include insomnia (fairly common), nausea, dry mouth, decreased libido, sweating, agitation, urinary retention, and dizziness. Again, I'll go over specifics when discussing each drug.
Table 21-3 in your Manual of Psychiatric Nursing Care Planning book has an excellent overview of these drugs.
Atypical Antidepressants are up next. This information seems somewhat scattered and incomplete in the book, so I will do my best to write what I know and can find. Please correct my mistakes!
Just like the name suggests, these medications are used to treat depression. They work in a similar way to SSRIs... they inhibit the reuptake of either serotonin, norepinephrine, dopamine, or a combination of these neurotransmitters. When I go over each drug, I'll go into more detail!
What about side effects? Good question. There are specific side effects for each drug, and they generally include insomnia (fairly common), nausea, dry mouth, decreased libido, sweating, agitation, urinary retention, and dizziness. Again, I'll go over specifics when discussing each drug.
Table 21-3 in your Manual of Psychiatric Nursing Care Planning book has an excellent overview of these drugs.
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